Many serious complications may occur after a female gives birth by cesarean section and then becomes pregnant again. Some of these complications are caused by full-thickness defects in the uterine wall at the hysterotomy closure site. These complications include abnormal placentation and uterine rupture at the hysterotomy closure site.
Of the various types of abnormal placentation, there are three notable types including: placenta accreta, placenta previa, and placenta percreta. Placenta accreta is a condition where the placenta abnormally attaches itself to the surface of the uterine wall and has grown into the myometrium-the muscle of the uterine wall. Placenta previa is a condition wherein the placental attachment site extends into the lower uterine segment and can grow to cover the internal cervical os; this condition poses a serious complication for normal vaginal delivery. Placenta percreta is a condition wherein the placenta grows through the uterine wall and into the abdominal cavity. Because the placenta is such a fast growing organ, once into the adnominal cavity, the placenta poses the risk of attaching to the bladder, rectum, bowl, or other nearby organs.
Each type of abnormal placentation poses risk to both the mother and the fetus. First, the mother risks hemorrhaging should the integrity of the placenta be disrupted in such a manner that causes the vessels connecting the placenta to the uterine wall to rupture or detach. The fetus is also at risk because such complications may cause miscarriage, abnormal fetal growth, oligohydramnios, force preterm delivery, or intrauterine fetal death.
The incidence of abnormal placentation and uterine rupture at the hysterotomy closure cite increase as the number of cesarean sections the mother has increases. The correlation between the abnormal placentation and uterine rupture with cesarean are linked to the fact that hysterotomy closures fail to restore the integrity of the pre-hysterotomy uterus. The compromised site that can result in abnormal placentation or uterine rupture often means vaginal birth after cesarean will not be successful; therefore, the mother will need to undergo another cesarean delivery.
What is needed is an apparatus and method to decrease the incidence of abnormal placentation and uterine rupture that result from cesarean section. What is also needed is an apparatus and method for restoring the anatomic integrity of the uterus at the hysterotomy surgical site. Additionally, what is needed is an apparatus and method for reconnecting uterine tissue in such a way so as not to disturb the involution of the postpartum uterus that occurs over the initial six-weeks of postpartum.